Report: Delays Possible for Tennessee’s Uninsured

By Jennifer Johnson Backer

A government watchdog report released last week pointed to delays in setting up consumer assistance programs in states that have opted for federally run health insurance marketplaces, like Tennessee.

The Government Accountability Office report released Wednesday, June 19, said the Centers for Medicare & Medicaid Services (CMS) was two months late in announcing grant funding for groups including hospitals, county health agencies, religious groups and chambers of commerce that will help consumers navigate the new marketplaces and enroll in health care insurance.

In April, the federal government announced it had set aside $54 million in “navigator” grant funding to be distributed to groups in the 34 states that have opted for federally run health care exchanges. The funding will be distributed based on the number of uninsured consumers in each state.

With less than 100 days to the deadline for opening the online marketplaces on Oct. 1, consumer advocates are concerned that the uninsured in states with federally-run exchanges won’t get as much assistance as those in states that are setting up their own exchanges. The Affordable Care Act provides generous funding to states like California that are running their own exchanges, but has provided as little as $600,000 to states with federally run exchanges.

Polls show many Americans know little about the Affordable Care Act and how it will affect them.

While California has budgeted $50 million for in-person consumer help, Tennessee has received $1.48 million in funding to help enroll the state’s estimated 889,016 citizens that lack health care insurance.

Timothy Finnell, the president of Group Benefits LLC, said he thinks the federal government will fall far short of the 7 million uninsured Americans it says it hopes to enroll by the end March.

But Finnell says he would attribute the challenges in encouraging people to sign up for health care coverage to the cost of coverage and the level of coverage provided, rather than the lack of funding for marketing outreach and enrollment efforts.

Many consumers, particularly younger, healthier individuals, may opt to pay the $95 tax penalty in 2014, rather than purchasing more costly insurance coverage on the exchanges, he said.

The Congressional Budget Office has said an estimated 24 million Americans will get health insurance coverage through the exchanges by 2022, but only about 7 million will enroll in the first year.

Memphis hospitals contacted by The Daily News said they hope to partner with community organizations that are awarded navigator grants to help guide local residents through the enrollment process. While all the local hospitals contacted declined to be interviewed on the record, some said they are considering running their own outreach efforts to help enroll the uninsured.

Nonprofit hospitals also were eligible to apply for the federal navigator grant funding. CMS gave applicants until June 7 to submit their applications. While CMS planned to begin navigator training in July, under its current plan the agency will not announce the navigator grant recipients until Aug. 15. Training will not begin until at least September, just a month before initial enrollment is set to begin on Oct. 1.

Enrolling Memphis’ uninsured population is critical for area hospitals as they grapple with fewer reimbursements from Medicaid and Medicare, in addition to losing millions annually on providing unreimbursed care to the uninsured. Hospitals in Memphis and across Tennessee will have to comply with the Affordable Care Act mandates without an additional $1.4 billion in Medicaid money to provide health care and other services for the uninsured.

While the GAO report warned about missed deadlines for community outreach, regulators also warned that the deadlines missed so far will likely not impact the law’s implementation, but the “still-unknown and evolving scope of the exchange activities CMS will be required to perform in each state, and the large number of activities remaining to be performed – some close to the start of enrollment – suggest a potential for implementation challenges going forward.”

Among other hurdles, the report raised concerns about testing of computer systems and other key activities like technology systems that will deal with eligibility and enrollment in the federal exchanges.

“… While missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so…whether CMS’ contingency planning will assure timely and smooth implementation of the exchanges by October 2013 cannot yet be determined,” according to GAO regulators.